Effect of Nested and Swaddled Prone Positioning on Sleep and Physiological Parameters of Low Birth Weight Neonates
[1]
Gehan Maher, Department of Pediatric Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
[2]
Wafaa Elarousy, Department of Pediatric Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
Nesting position is a comfort measure that simulates in-utero feeling of lack of space by providing a “nest” with a rolled blanket. Nesting facilitates deep peaceful sleep pattern, the flexed posture reduces the surface area exposed to the environment, minimizing heat loss. The aim is to determine the effect of nested and swaddled prone positioning on sleep and physiological parameters of low birth weight (LBW) neonates. Design: Experimental design was used in the study. Setting: This study was conducted at the Neonatal Intensive Care Unit of Maternity University Hospital at El-Shatby in Alexandria. Methods: Convenient sampling for 60 LBW neonates was used, randomly allocating the first neonate either to control or experimental group. Then, the others LBW neonates of each group were chosen alternatively. Thirty neonates were received nested position (study group) and other 30 neonates were received prone position only (control group). Neonates’ physiological parameters and sleep state using sleep state assessment observational checklist were assessed for all neonate. Results: The mean neonates’ heart rate was 143.40 ± 14.95 after nesting compared with 157.57 ± 15.88 for neonates of control group and the differences were statistically significant. Furthermore, the mean Oxygen saturation of neonates in study group was higher than in the control group (97.43 ± 1.47, 95.63 ± 0.76 respectively) and the differences were statistically significant. In addition, it was found that 43.3% of neonates of study group and 10% of neonates in control group were in deep sleep and the differences between both groups were statistically significant. Conclusion: It can be concluded that nested and swaddled position improve sleep and physiological parameters compared to prone position alone among LBW neonates.
Low Birth Weight Neonates, Nesting Position, Prone Position, Sleep
[1]
WHO (2014) WHA Global Nutrition Targets 2025: Low Birth Weight Policy Brief.
[2]
Chen Y, Li G, Ruan Y, Zou L, Wang X, et al. (2013) An epidemiological survey on low birth weight infants in China and analysis of outcomes of full-term low birth weight infants. BMC Pregnancy and Childbirth 13: 242.
[3]
Poulose R, Babu M, Rastogi SH (2015) Effect of Nesting on Posture Discomfort and Physiological Parameters of Low Birth Weight Infants. Journal of Nursing and Health Science 4: 46-50.
[4]
Prasanna K, Radhika M (2015) Effectiveness of Nesting on Posture and Motor Performance Among Newborn babies. IJSR - International Journal of Scientific Research. IV (IV): 149.
[5]
Ferrari F, Bertoncelli N, Gallo C, Roversi M, Guerra M et al. (2007) Posture and movement in healthy preterm infants in supine position in and outside the nest. Arch Dis Child Fetal Neonatal Ed 92: F386-F390.
[6]
Zarem C, Crapnell T, Tiltges L, Madlinger L, Reynolds L, et al. (2013) Neonatal Nurses’ and Therapists’ Perceptions of Positioning for Preterm Infants in the Neonatal Intensive Care Unit. Neonatal Netw 32: 110-116.
[7]
Zahed M, Berbis J, Brevant- Malaty V, Busuttil M, Tosells B, et al. (2015) Posture and movement in very preterm infants at term age in and outside the nest. Childs Nrev. Syst, Springer-Verlag Berlin Heidelberg 31: 2333-2340.
[8]
Comaru, T., Miura, E. (2009). Postural support improves distress and pain during diaper change in preterm infants, Journal of Perinatology. 29 (7): 504–507.
[9]
Kihara H, Nakamura T (2013) Nested and swaddled positioning support in the prone position facilitates sleep and heart rate stability in very low birth weight infants. Research and Reports in Neonatology 3: 11-14.
[10]
Madlinger-Lewisa L, Reynoldsb L, Zarema C, Crapnella T, Inderc T, et al. (2014) The Effects of Alternative Positioning on Preterm Infants in the Neonatal Intensive Care Unit: A Randomized Clinical Trial. Res Dev Disabil 35: 490-497
[11]
Allen K (2012) Promoting and Protecting Infant Sleep. Adv Neonatal Care 12: 288-291.
[12]
Halverson K (2010) The Effects of Positioning on Premature Infant Development. Pediatrics CATs.
[13]
Waitzman A (2014) The importance of positioning the near-term infant for sleep, play and development. Newborn and Infant Nursing Reviews 7: 76-81.
[14]
El-Nagger N, Bayoumi O (2016) Effect of applying nesting technique as a developmental care on physiological functioning and neurobehavioral organization of premature infants. Life Science Journal 13: 97-72.
[15]
Prasenjit H, Debabrata B, Arindam B (2015) Developmentally Supportive Care. In: Neonatal Intensive Care Unit (NICU): A Review. Indian Journal of Medical Research and Pharmaceutical Sciences 2: 34.
[16]
Picheansathian W, Woragidpoonpol P, Baosoung C (2009) Positioning of preterm infants for optimal physiologic development: A systematic review. Joanna Briggs Institute Library of Systematic Reviews 7: 224-59.
[17]
Bastani F, Rajaei N, Amini E, Haghani H, Jan Mohamadi S (2012) Assessment of preterm Infants Who Sleep in the NICU and its Relationship with Demographic Variables. Alborz University of Medical Sciences Journal 2: 1-6.
[18]
Rahimi O (2014) The importance of neonatal sleep care in Neonatal Intensive Care Unit. JCE 2: 83-98.
[19]
Reyhani T, Ramezani S, Boskabadi H, Mazlom S (2016) Evaluation of the Effect of Nest Posture on the Sleep-wake State of Premature Infants. Evidence Based Care Journal 6: 29-36.
[20]
Baley J (2015) Committee on Fetus and Newborn. Developmental Care for Term and Preterm Infants in the Neonatal. Pediatrics 136: 596.
[21]
Cole P, Gavey J (2011) Are they lying comfortably? A direct observational study examining current practices of infant positioning in the neonatal unit. Journal of Neonatal Nursing 7: 25-32.
